5 Ways a Medical Fraud Defense Lawyer Can Protect You

Medical fraud is complex and nuanced, and a general attorney is unlikely to know all the relevant laws. If your practice has received an audit letter or you believe that you are on the government’s radar, you shouldn’t delay contacting a medical fraud defense lawyer. This professional can perform a thorough investigation to determine your chances of winning your case. As a result, you may be able to stay out of jail and keep your Medicare or Medicaid license. 


5 Ways a Medical Fraud Defense Lawyer Can Protect You


1. They Can Help You During an Audit 

It is estimated that money lost due to fraud makes up 3-10% of all healthcare expenditure. While this might not sound like much, it adds up to billions of dollars every year. For this reason, the government regularly audits medical practices that offer Medicare and Medicaid treatments. If you’ve received an audit letter, contacting a fraud defense lawyer could be a good idea

The attorney can go through your records and figure out whether there are any potential problems. If so, they will work together with you to build up a defense or, if it’s probable that you would lose a court case, advise you to negotiate with the government early on. The faster you act, the less likely you are to face severe consequences such as a suspension of your Medicaid or Medicare number.

2. They Can Remove You from the Government’s Radar 

It is believed that many healthcare professionals, clinics, and hospitals committed fraud during the COVID pandemic. Thus, countless clinics are now on the government’s radar and at risk of an administrative audit. If you’ve been contacted by the FBI, you should speak to a defense lawyer before agreeing to an interview. The attorney can let you and your staff know what your legal rights are.

Sometimes, it’s possible to avert fraud charges, especially if the government doesn’t have adequate proof and the value of the fraud is low. For example, you could make a deferred prosecution agreement, which allows the investigations to be paused while you comply with the agreement’s terms. Once you’ve fulfilled the requirements within the set timeframe, the case can be dropped, and you’ll be able to continue practicing medicine as before.

3. They Can Prevent You from Losing Your License 

If you’re caught committing medical fraud, it’s likely that you will lose your Medicare or Medicaid license. This results in the loss of a large portion of your patients. Additionally, you might no longer be seen as a trustworthy professional, which can further jeopardize your position as a healthcare provider in your community. 

When you hire an experienced attorney, they will spend some time assessing your case and let you know what your chances are at trial. If the lawyer believes that you will be found guilty, they might advise you to cooperate with the government. That way, you could receive a plea agreement, which significantly reduces your chances of losing your license.

4. They Can Help You Stay Out of Jail and Prevent Financial Losses 

People who commit medical fraud might go to jail for up to 10 years. It goes without saying that this should be avoided at all costs since it can ruin a healthcare professional’s career and personal life. But even if you aren’t imprisoned, you might have to pay an extremely high fine. If you are convicted of filing a false claim, you will need to pay $11,000 and up to three times the amount of the claim. 

Each item billed to either Medicaid or Medicare counts, so the money you owe can add up quickly. If you contact a good defense lawyer as soon as you’re contacted by the FBI, you may be able to avoid both the fine and incarceration.  

5. They Can Help You Prevent Future Problems 

Once your case is over, you’ll want to prevent further issues and remain compliant. A good attorney won’t leave you to it after they’ve won your case. Instead, they will speak to you about how to restructure your business so that you never have issues with fraud again. For instance, they might advise you to perform a gap analysis and an internal investigation on a regular basis. 

It’s important to remember that the government is increasingly strict when it comes to fraud, so it’s likely that new laws will be developed in the future. Great medical fraud defense lawyers can help you develop a system that allows you to update your compliance policies on a regular basis and therefore remain current.

If you believe that the government has your medical practice on its radar, you should speak to a fraud defense lawyer about your options. They know all the relevant laws and can therefore let you know how to proceed. As a result of their expertise, your fraud attorney could prevent you from losing your license, having to pay millions in damages, and going to jail. Additionally, they can help you remain compliant in future years.



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